Objective.—To estimate nationally what percentage of young women receive negative pregnancy test results before becoming pregnant, to explore their fertility and test histories, and to estimate the potential for intervention at the time of a negative test result.

Design.—A cross-sectional study in which young women presenting to clinics for pregnancy tests were asked to complete a self-administered questionnaire before test results were known that explored prior pregnancy tests, pregnancies, sexual and contraceptive histories, and childbearing attitudes.

Participants.—A total of 2926 patients aged 17 years or younger requesting pregnancy tests at presentation.

Results.—Among young women who had ever conceived, 34.2% had a prior negative pregnancy test result and 24.4% had a prior negative test result at a clinic. Almost three of five of the adolescent girls, including both those who had and those who had not conceived, received a negative test result at a clinic before they ever became pregnant. By the age of 14 years, the probability of a negative test result was substantially greater than the chance of a positive test. Many presented for tests even though they were quite certain that they were not pregnant.

Conclusions.—Adolescent girls with a negative pregnancy test result may be an appropriate target group for intervention. One fourth of adolescent girls who have a negative pregnancy test may be identified by the health care system on that occasion in time to prevent early childbearing.(JAMA. 1996;275:113-117)